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Building Rehab Protocols in Youth Development Environments

Unfortunately, injury is a part of sport, a part of physical activity and a part of life. If we, as youth development coaches can piece together “return-to-play” protocols, we will go a long way in easing the anxiety and stress for our students, parents, coaches & their respective communities.

In my experience, injury rehab programs are often a copy & paste job, a one size fits all approach or are built for elite athletes …. expensive equipment (ie. Force Plates) & multiple full-time staff (ie. Physiotherapists, Rehab S&C Coaches. Working in the youth sector environment, we generally have Zero to minimal budget, severely understaffed & are casual/Part-Time employed. So this blog post will guide you through how to build your own “shoe-string budget” rehabilitation program for the major injuries you see!!

Strong Communication Line with Medical Professionals

I’ve worked within the youth development space for over 10 years now, and in this time, I have yet to see a full-time Physio or Doctor employed at any organisation (obviously excluding Sporting/ Professional Academy’s). This means we have to be on the front foot with referring, chasing & pushing our kids to see these health professionals. However, that’s the easy part!! Once we get them there, we are generally are relying on the student-athlete to re-tell critical information. How many times have you had this……

Athlete: “Yeah, I saw the physio yesterday and I think they said I had a ankle strain or something”.

Coach: “Did the physio write down any rehab exercises for you??”

Athlete: “Aahhh, yeah but I lost the sheet”

Coach: “Do you remember any of your exercises??”

Athlete:Yeah, I think so”, as they demonstrate what appears to be an attempted calf raise

I get around this now by finding out the practice and name of the physio who saw the individual. This means I can then hear it from the horse’s mouth instead of playing a shitty game of Chinese whispers! With this, now accurate, information I can begin to build a structured rehab program, whilst the physio/doctor now have an understanding who the injured client will be working with…. Think proactive, driven, team orientated, open etc.

An even better way is to build up a close network of physio’s/Doc’s as this builds trust, greater communication & less work for you as one phone call can discuss multiple athletes. I’m very lucky in my current job to have a physio WHO NOW CALLS ME!!!!

Criteria-based Progression Through Rehabilitation

One of the biggest (and most common) mistakes we can make in the rehabilitation process is to give an athlete timeframe-based return-to-play information. For example, a student rolls their ankle… you’ll be back in 3 weeks. Although this information can often be somewhat accurate, it actually causes more problems that is solves. Firstly, the athlete now assumes time will fix the injury not targeted rehabilitation. Secondly, I’ve found that timeframe-based rehabilitation will not drive the athlete to try get back earlier – rather just wait out the injury. And lastly, when an injury takes longer than the specified time, athletes become dejected, unmotivated and in extreme cases can lose confidence in those prescribing rehab (physio, S&C, Doctor etc.)

The way to solve all these problems is to prescribe goal or criteria-based targets rather than timeframes. For example, after a lower body injury, before you can begin to run in straight line you must pass these “X” criterion, before you can start change of direction/agility work you must pass these “Y” criterion  and before I allow you back into full training you must pass these “Z” criterion.

Setting criterion is not solely the job of S&C’s but a whole team approach from physiotherapists, doctors & athletic development coaches. In my setting we built our rehab protocols with our main physio & sports doctorand they are displayed on the gym wall. This allows the injured athlete to know exactly what they need to achieve to progress to the next stage of rehab. It creates motivated athletes, who know their rehab plan and they are the masters of the return to play… not the rehabilitation staff.

Athlete Centred Approach

Lastly, yet most importantly, the student/athletes’ best interests MUST be at the centre of each and every decision made. Too often in youth sport I have seen young kids rushed back as they are a “star” player and they will help us win this competition. In the end it is only youth sport, they are not playing for sheep stations. A team’s desire to win an underage sporting game must NEVER be put ahead of the risk of long-term injury to a kid.

Include the injured athlete in all decisions being made around their progression as they’ll have a good idea if their ready to go…. Just give them the opportunity to speak.

In summary, we don’t need an expensive budget to put together a sound rehabilitation program in youth sport. All we need is a rock-solid communication line with medical professionals, a goal based rehabilitation plan (not a timeframe-based one) & always, always, ALWAYS put the student-athlete first.

Reach out if you want to discuss more on this topic

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